On 3 August, Dr Migita D’cruz and Dr Debanjan Banerjee of the National Institute of Mental Health and Neurosciences in Bangalore published an advocacy review in Psychiatry Research, describing how social and health factors have particularly marginalised older adults during the COVID-19 pandemic.
In their review, the authors summarise the direct and indirect risks to older adults during the COVID-19 pandemic, many of which are unique to this age group. In terms of direct risks, the most well-studied is the increased risk of COVID-19 morbidity and mortality in older adults. Less well-studied are the increased risks of adverse drug reactions when treated with COVID-19 drugs such as interferon- or plasma therapy. Indirect risks include loneliness and social isolation, elder abuse and, crucially, ageism: the authors draw attention to media reports that normalise ageist beliefs, calling on older adults to remain at home and not burden health systems.
As a result of these direct and indirect risks, the authors argue that older adults are experiencing increased marginalisation and societal exclusion, amplified by the utilitarian approach to physical distancing employed by many governments. These approaches have led to isolation of older adults in the community, removing them from their usual support structures and compounding pre-existing inequalities.
Highlighting the Alzheimer Europe position statement on triage decisions during the COVID-19 pandemic, Drs D’cruz and Banerjee call for older adults to be prioritised for access to protective equipment and testing, with greater investment in public health strategies that ensure continuity of care despite lockdown measures. Of note, the authors draw attention to recent reports indicating that some people with dementia have experienced worsening symptoms during COVID-19 lockdown, recommending home-based physical and cognitive activities that could have therapeutic benefit for these groups. They emphasise that older adults should be included as active stakeholders in healthcare, embedding the principles of Healthy Ageing in the development of public health strategies to address the COVID-19 pandemic.
https://www.sciencedirect.com/science/article/pii/S0165178120324811
